My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
SOUTHLAND CAR COUNTERS 4 - 2003
Clerk
>
Contracts / Agreements
>
_PENDING FOLDER
>
READY TO DESTROY IN 2018
>
SOUTHLAND CAR COUNTERS 4 - 2003
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
1/3/2012 2:09:45 PM
Creation date
8/5/2003 3:27:58 PM
Metadata
Fields
Template:
Contracts
Company Name
Southland Car Counters, Inc.
Contract #
A-2003-139
Agency
Public Works
Council Approval Date
7/7/2003
Expiration Date
6/30/2005
Insurance Exp Date
9/30/2005
Destruction Year
2010
Notes
Amended by A-2003-139-01
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
45
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
SP <br />ERTHOLOER.COPY <br />STATE _ P.O. BOX 807, SAN FRANCISCO,CA 94142-0807 <br />CORAPEN'SATION <br />INSURAN.`CE <br />U N D CERTIFICATE OF .WORKERS' COMPENSATIQN INSURANCE <br />ISSUE DATE: 04-01-2003 'GROUP: <br />POLICY NUMBER: 1296302-2003 <br />"' ` CERTIFICATE ID: 43 <br />CERTIFICAT€ EXPIRES: 04-01-2004 <br />04-Oi-2.003f04-O1-2004 <br />C f TY OF SANTA ANA SP Z <br />ATTN °ILIONA DE ROSA CONTRACT.SPECIALfST E ~~++ <br />20 CIVIC CENTER PLAZA M-43 ~ ~'y <br />SANTA ANA CA 92702' <br />This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved try .the <br />California Insurance CG17irrlissiOner to the e„~ploysr named. balaw far the aohCy pericd ind.catcd. <br />This policy is not subject to cancellation by -the .Fund except upon 30 days' advance written notice to the employer. <br />We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration. <br />This certificate of insurance is .not an .insurance policy and does not amend, extend or alter the coverage afforded <br />by the policies,;<{fisted herein. Notwithstanding any requirement, 4erm, or condition of any 'contract :or other document <br />with respect,_tp which this°certificate of insurance may be issued or may.pertam,::'the .insurance:afforded" by the <br />policies described herein is subject to all the terms, exclusions and conditions of such policies. <br />AUTHORIZED REPRESENTATIVE PRESIDENT <br />EMPLOYER'S:,LIABILITY LIMIT INCLUDING DEFENSE COSTS: ..$1,000,000.00 PER OCCURRENCE. <br />ENDORSEMENT 1{3065 ENTITLED CERTIFICATE HOLDERS' NOTIGE'EFFECTIVE 04-01-2003 IS ATTACHED TO AND <br />FORMS A PART OF THIS POLICY.' <br /><. k ~~Uw:Ell, AS 70 FORI,: <br />,4 T <br />,. <<; City Attorney. <br />EMPLOYER <br />LEGAL NAME <br />SQUTHLAND :CAR COt1NTERS sourH~AN~ COMMUNICATIONS & DATA INC <br />1407 N_ BATA,V I A ST STE 107 <br />ORANGE CA 9286.7 <br />PRINTED: 03-17-2003 P0408 <br />~• ~ - -• ~ ~ <br />
The URL can be used to link to this page
Your browser does not support the video tag.